A community-level educational intervention trial to study the impact of lifestyle modification in control of hypertension and diabetes: A nonrandomized trial (before-and-after intervention study without control)

Abstract

Background: Dietary habits and physical inactivity are related to the risks of noncommunicable diseases (NCDs), such as cardiovascular diseases. It is essential that lifestyle modification and nondrug treatment measures such as health education, reduction in weight through regular exercise, and changing in eating patterns are essential to control diabetes and hypertension. Hence, the present study is taken up with objectives. Objectives: The objectives of this study were as follows: (1) to assess and compare the impact of health education on lifestyle modification (diet modification and physical activity) on control of hypertension and diabetes of intervention group and (2) to assess and compare the practice of changed pattern of lifestyle modification (diet modification and physical activity) of known hypertensives and diabetics with continuous health education module and follow-up. Methodology: This community-level education intervention trial to reduce the burden of NCDs (hypertension and diabetes) was conducted in coastal Karnataka. The study was taken up in a rural area of coastal Karnataka. A Module was prepared, which address the physical activity, diet modification of Diabetes mellitus patients and Hypertension. This modules were reviewed and approved by the experts in the field. This module was used for training health workers. Here the intervention was directed to the family member, who actually cook for Diabetes and hypertension patient, so that the intervention planned would be implemented.Results: In the study subjects, it was observed that the subjects who had higher systolic and diastolic pressure before intervention changed to the lower levels after intervention, though the change in blood pressure (BP) is not statistically significant. In the intervention of overall lifestyle intervention, there were increased subjects with glycated hemoglobin (Hb1Ac) in the range of 7%–9% and reduced subjects with Hb1Ac of >9.1%, though it was not statistically significant. There was a significant improvement in the mean duration of physical activity in order to control hypertension and diabetes mellitus. We also noticed that there was a reduction in the sedentary hours, though the difference was not statistically significant. Conclusion: Lifestyle intervention with continuous monitoring is essential to bring down the BP and diabetic sugars. The intervention of lifestyle modifications has brought in better care and quality of life in the villages compared to control village.

Keywords

• diabetes and hypertension
• lifestyle modification
• module-based education intervention